"I thought there would be more I understood": health insurance literacy among adolescent and young adult cancer survivors.

Autor: Waters AR; Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA. Austin.waters@hci.utah.edu., Mann K; Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA., Warner EL; University of Arizona Cancer Center, Tucson, AZ, USA.; University of Arizona College of Nursing, Tucson, AZ, USA., Vaca Lopez PL; Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA., Kaddas HK; Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA., Ray N; Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA., Tsukamoto T; Intermountain Healthcare, Salt Lake City, UT, USA., Fair DB; Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.; Primary Children's Hospital, Salt Lake City, UT, USA., Lewis MA; Intermountain Healthcare, Salt Lake City, UT, USA., Perez GK; Massachusetts General Hospital, Boston, MA, USA., Park ER; Massachusetts General Hospital, Boston, MA, USA., Kirchhoff AC; Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.; Department of Pediatrics, University of Utah, Salt Lake City, UT, USA.
Jazyk: angličtina
Zdroj: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer [Support Care Cancer] 2022 May; Vol. 30 (5), pp. 4457-4464. Date of Electronic Publication: 2022 Feb 02.
DOI: 10.1007/s00520-022-06873-2
Abstrakt: Background: Health insurance literacy is crucial for navigating the US healthcare system. Low health insurance literacy may be especially concerning for adolescent and young adult (AYA) cancer survivors. To describe AYAs' health insurance literacy, we conducted semi-structured interviews with AYA survivors, on and off of treatment.
Methods: We interviewed 24 AYA cancer survivors (aged 18-39 years) between November 2019 and March 2020. Interviews were recorded, transcribed, and quality-checked. Using two cycles of structured coding, we explored AYAs' health insurance literacy and examined thematic differences by policy holder status and age.
Results: AYAs were 58.3% female, 79.2% non-Hispanic White, 91.7% heterosexual, and 62.5% receiving cancer treatment. Most participants had employer-sponsored health insurance (87.5%), and 41.7% were their own policy holder. Four themes emerged; in the first theme, most AYAs described beginning their cancer treatment with little to no understanding of their health insurance. This led to the three subsequent themes in which AYAs reported: unclear expectations of what their insurance would cover and their out-of-pocket costs; learning about insurance and costs by trial and error; and how their health insurance literacy negatively impacted their ability to navigate the healthcare system.
Conclusions: Our findings, while requiring confirmation in larger samples and in other health systems, suggest that the health insurance literacy needed to navigate insurance and cancer care is low among US AYA survivors and may have health and financial implications. As the burden of navigating insurance is often put on patients, health insurance education is an important supportive service for AYA survivors on and off of treatment.
(© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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